首页|肺动脉重建矫治婴幼儿孤立性单侧肺动脉缺如的单中心回顾性队列研究

肺动脉重建矫治婴幼儿孤立性单侧肺动脉缺如的单中心回顾性队列研究

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目的 明确婴幼儿单侧肺动脉缺如(unilateral absence of pulmonary artery,UAPA)行肺动脉重建后肺动脉压变化、"新"肺动脉狭窄及再次手术情况.方法 回顾性分析2019年2月19日-2021年4月15日于广东省人民医院行肺动脉重建术UAPA婴幼儿的临床资料.术后随访其肺动脉压变化、"新"肺动脉狭窄及再次手术情况.结果 纳入5例患儿,其中男4例、女1例,手术年龄为13 d~2.7岁.5例患儿均行心脏增强CT扫描,其中2例行肺静脉逆行楔形造影明确诊断及术前评估.术前经胸超声心动图和术中肺动脉直接测压提示5例患儿均存在肺动脉高压,平均肺动脉压(31.3±16.0)mm Hg;肺动脉重建术中即时肺动脉压下降至(16.8± 4.2)mm Hg.平均随访(18.9±4.7)个月,随访期间5例患儿均存活;1例患儿出现"新"肺动脉狭窄而再次手术.结论 肺动脉重建矫治婴幼儿UAPA可有效缓解肺动脉高压,术后需密切随访"新"肺动脉通畅情况,必要时需再次行肺动脉成形术.
Pulmonary artery reconstruction to repair infant isolated unilateral absence of pulmonary artery:A retrospective cohort study in a single center
Objective To confirm the changes of pulmonary artery pressure,neo pulmonary artery stenosis and reoperation in children with unilateral absence of pulmonary artery(UAPA)undergoing pulmonary artery reconstruction.Methods The clinical data of the infants with UAPA undergoing pulmonary artery reconstruction in our hospital from February 19,2019 to April 15,2021 were analyzed.Changes in pulmonary artery pressure,neo pulmonary artery stenosis and reoperation were followed up.Results Finally 5 patients were collected,including 4 males and 1 female.The operation age ranged from 13 days to 2.7 years.Cardiac contrast-enhanced CT scans were performed in all children,and 2 patients underwent pulmonary vein wedge angiography to confirm the diagnosis and preoperative evaluation.Preoperative transthoracic echocardiography and intraoperative direct pulmonary arterial pressure measurement indicated that all 5 children had pulmonary hypertension,with a mean pulmonary arterial pressure of 31.3±16.0 mm Hg.Pulmnonary arterial pressure decreased immediately after pulmonary artery reconstruction to 16.8± 4.2 mm Hg.The mean follow-up time was 18.9±4.7 months.All 5 patients survived during the follow-up period,and 1 patient had neo pulmonary artery stenosis or even occlusion and was re-operated.Conclusion Pulmonary artery reconstruction can effectively alleviate the pulmonary hypertension in children with UAPA.The patency of the neo pulmonary artery should be closely followed up after surgery,and re-pulmonary angioplasty should be performed if necessary.

Pulmonary artery reconstructionunilateral absence of pulmonary arterycongenital heart diseases

闫新建、陈寄梅、岑坚正、温树生、许刚、崔虎军、刘晓冰、庄建

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广东省人民医院 广东省医学科学院 广东省心血管病研究所 广东省华南结构性心脏病重点实验室 小儿心脏外科(广州 510080)

肺动脉重建 单侧肺动脉缺如 先天性心脏病

广东省医学科学技术研究项目广东省登峰计划

A2022175DFJH201802

2024

中国胸心血管外科临床杂志
四川大学华西医院

中国胸心血管外科临床杂志

CSTPCD北大核心
影响因子:0.846
ISSN:1007-4848
年,卷(期):2024.31(4)
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